Fisher Dale, Michaels Jessica, Hase Ryota, Zhang Jing, Kataria Sushila, Sim Benedict, Tsang Joseph Kay-Yan, Pollard James, Chan Monica, Swaminathan Subramanian
Infectious Disease Division, Department of Medicine, National University Hospital, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
J Antimicrob Chemother. 2017 Apr 1;72(4):1221-1226. doi: 10.1093/jac/dkw551.
Healthcare facilities internationally have grown outpatient parenteral antibiotic administration services for the last few decades. The literature contains publications from dozens of countries describing systematized processes with specialist oversight and their levels of service provision and outcomes. Such descriptions are absent in the majority of Asian countries. We sought to elucidate the extent and nature of outpatient parenteral antibiotic therapy (OPAT) in Asia and to consider the ramifications and opportunities for improvement.
Utilizing colleagues and their personal networks, we surveyed healthcare facilities across 17 countries in Asia to ascertain the current means (if any) of providing OPAT. In that survey we also sought to explore the capacity and interest of these facilities in developing systematized OPAT services.
Responses were received from 171 different healthcare facilities from 17 countries. Most (97/171, 57%) stated that they administer outpatient parenteral antibiotics, but only 5 of 162 facilities (3%) outside of Singapore described comprehensive services with specialist oversight.
There is very likely a large unrecognized problem of unchecked outpatient parenteral antibiotic administration in Asia. Developing comprehensive and systematized OPAT in Asia is needed as a priority in an environment in which the infectious diseases community is demanding broad stewardship approaches. There are nonetheless challenges in establishing and sustaining OPAT programmes. Local champions and leverage off identified local incentives and needs are key to regional advancement.
在过去几十年里，国际上的医疗机构增加了门诊胃肠外抗生素给药服务。文献中有来自几十个国家的出版物，描述了在专家监督下的系统化流程及其服务提供水平和结果。大多数亚洲国家缺乏此类描述。我们试图阐明亚洲门诊胃肠外抗生素治疗（OPAT）的范围和性质，并考虑改进的影响和机会。
我们利用同事及其个人网络，对亚洲17个国家的医疗机构进行了调查，以确定目前提供OPAT的方式（如果有的话）。在那次调查中，我们还试图探索这些机构开展系统化OPAT服务的能力和兴趣。
收到了来自17个国家171家不同医疗机构的回复。大多数（97/171，57%）表示他们提供门诊胃肠外抗生素治疗，但新加坡以外的162家机构中只有5家（3%）描述了有专家监督的综合服务。
在亚洲，很可能存在一个未被充分认识的门诊胃肠外抗生素使用缺乏管控的大问题。在传染病领域需要广泛管理方法的环境下，亚洲优先需要发展全面且系统化的OPAT。然而，建立和维持OPAT项目仍存在挑战。当地的倡导者以及利用已确定的当地激励措施和需求是区域进步的关键。
